title: Causes of smoking in Pakistan: an analysis of social factors.
abstract: OBJECTIVE
  To determine the factors contributing to the initiation and propagation of smoking in visitors to a major tertiary health center in Karachi, Pakistan.
  
  
  METHODS
  Seven major contributing factors to the initiation and propagation of smoking were presented to consenting study participants (n=170) in a questionnaire. Participants were then requested to use their experience and opinion to rate each of the given factors on a scale of 1 to 5 regarding its importance as a causative factor in the initiation and propagation of smoking. Results were analyzed using SPSSv16.0.
  
  
  RESULTS
  Preliminary analysis revealed occupational stress relief as the most important factor contributing to smoking with a mean score of 3.25 +/- 1.32. Peer pressure ranked second (Score 3.20 +/- 1.42). Domestic stress relief ranked third with a score of 3.19 +/- 1.32. Smokers gave lower rating than non-smokers to most factors. Younger participants gave higher ratings to peer pressure, and most participants were found to have begun smoking at a young age.
  
  
  CONCLUSIONS
  Even though the addictive power of nicotine or stress may appear as a factor in middle aged smokers, the root of their habit lies in the initiation due to peer pressure.
authors.affiliation: Medical College, Aga Khan University, Karachi, Pakistan.
authors.forename: Sobia
authors.initials: S
authors.lastname: Nizami
authors.forename: Zain A
authors.initials: ZA
authors.lastname: Sobani
authors.forename: Emmon
authors.initials: E
authors.lastname: Raza
authors.forename: Noor-ul-Ain
authors.initials: NU
authors.lastname: Baloch
authors.forename: Javaid A
authors.initials: JA
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016739:Behavior, Addictive; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D010379:Peer Group; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult